This chapter describes the Coping Skills Program, an innovative, school-based, universal curriculum for elementary-school aged children that is rooted in cognitive behavior theory. Rooted in cognitive behavior theory, the Coping Skills Program consists of carefully constructed metaphorical fables that are designed to teach children about their thinking; about the connections among their thoughts, feelings, and behavior; and about how to change what they are thinking, feeling, and doing when their behavior causes them problems. The chapter provides a thorough description of the Coping Skills Program and how it is implemented through a discussion of relevant research-based literature, and the theoretical underpinnings underlying this cognitive behavior approach with school-aged children. It also includes the results of preliminary testing of the Coping Skills Program. The research-based literature shows that cognitive behavior approaches are among the interventions commonly used by social workers to help young children in school settings.
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This chapter integrates elements and strategies of internal family systems (IFS) psychotherapy into eye movement desensitization and reprocessing (EMDR) therapy with complexly traumatized children. It shows a description of healing a part using in-sight with a child. In-sight involves having the client look inside to find and work with parts that he or she sees or senses and describes to the therapist. The IFS therapist starts by ensuring the client’s external environment is safe and supportive of the therapy. In a self-led system, polarizations are absent or greatly diminished, leaving more harmony and balance. However, when and how the self is formed may be seen and conceptualized through different lenses in adaptive information processing (AIP)-EMDR and IFS. According to the AIP model, the human brain and biological systems are shaped by the environmental experiences they encounter.
This chapter clarifies treatment throughout the similarities as well as the differences between eye movement desensitization reprocessing (EMDR) therapy and sensorimotor psychotherapy in child treatment. Dysregulated arousal and overactive animal defenses biased by traumatic experience are at the root of many symptoms and difficulties observed in traumatized children. Traumatic or adverse experiences are encoded in memory networks in the brain. The adaptive information processing (AIP) looks at different components of the memory network: cognitive, emotional and somatic. EMDR therapy and its phases access not only the cognitive aspects of the memory, but the affective and bodily states. In working with children, microphones may add a playful approach to translating the body’s language. Oscillation techniques are also useful in helping children to shift their focus from dysregulated states to a more resourced experience, which supports flexibility in state shifting and increases awareness of different states.
This book is intended to provide to the eye movement desensitization and reprocessing (EMDR) clinician advanced tools to treat children with complex trauma, attachment wounds, and dissociative tendencies. It covers key elements to develop case conceptualization skills and treatment plans based on the adaptive information processing (AIP) model. A broader perspective is presented by integrating concepts from attachment theory, affect regulation theory, affective neuroscience, and interpersonal neurobiology. These concepts and theories not only support the AIP model, but they expand clinicians’ understanding and effectiveness when working with dissociative, insecurely attached, and dysregulated children. The book presents aspects of our current understanding of how our biological apparatus is orchestrated, how its appropriate development is thwarted when early, chronic, and pervasive trauma and adversity are present in our lives, and how healing can be promoted through the use of EMDR therapy. In addition, it provides a practical guide to the use of EMDR within a systemic framework. It illustrates how EMDR therapy can be used to help caregivers develop psychobiological attunement and synchrony as well as to enhance their mentalizing capacities. Another important goal of the book is to bring strategies from other therapeutic approaches, such as play therapy, sand tray therapy, Sensorimotor Psychotherapy, Theraplay, and Internal Family Systems (IFS) into a comprehensive EMDR treatment, while maintaining appropriate adherence to the AIP model and EMDR methodology. This is done with the goal of enriching the work that often times is necessary with complexly traumatized children and their families.
Stimulants are subject to abuse and addiction, lead to increased cocaine abuse in young adulthood, suppress growth, threaten cardiovascular functions, discourage the child’s sense of independence and personal mastery. There are always better therapeutic and educational alternatives to diagnosing and drugging children with attention deficit hyperactivity disorder (ADHD)-like symptoms. Drugs that lower blood pressure are frequently sedating, and any sedating drug is likely to be used in psychiatry for various purposes. Intuniv is a long-acting form of the antihypertensive drug guan-facine and has been approved for the treatment of ADHD. Catapres is another antihypertensive drug frequently given to children for its sedative properties and poses cardiac risks and in combination with stimulants can cause fatal cardiac arrest. The long-term cardiovascular risks from exposing children to these antihypertensive drugs would suggest grave caution in prescribing them to children.
The Maze, as a metaphor for a place where problems live and are solved, was developed out of the necessity of working with children who were too anxious, embarrassed, or afraid to experience the uncomfortable feelings around their problem areas. Such children often present as actively oppositional or sullenly silent. It was necessary to find a distancing technique that was both nonthreatening and interesting to gradually establish communication between therapist and child about issues that cause them discomfort. The main purpose of the maze is to gradually sensitize the child to the possibility of exploring the defended inner space where unpleasant, scary emotions dwell. The maze is a concept with which most children are acquainted. They have experienced both feelings of frustration and competence as they followed the convoluted lines with their pencils in workbooks. The elements of the protocol for maze include the following: maze, drawings and footsteps.
The Absorption Technique for Children is a protocol that was derived from the work of Arne Hofmann who based his work on an adaptation of “The Wedging Technique”. The absorption technique for children is a resource technique that supports children in creating resources for present issues and future challenges such as dealing with a difficult teacher or handling a disagreement with a classmate and so forth. This chapter uses resource installation for stressful situations. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. The absorption technique, and the constant installation of present orientation and safety (CIPOS) technique, are excellent ways to encourage children to work with eye movement desensitization and reprocessing (EMDR) step-by-step even if they are not prepared to work with the worst issue in the beginning.
- Go to chapter: The Method of Constant Installation of Present Orientation and Safety (CIPOS) for Children
The Method of Constant Installation of Present Orientation and Safety (CIPOS) for Children. The fundamental idea of the Method of Constant Installation of Present Orientation and Safety (CIPOS) is to reinforce a client’s current sense of security and stability using bilateral stimulation. The CIPOS method is helpful in assisting children to overcome their fear of their traumatic memories. Drawing and active movement is helpful when working with younger children and for the older, active child as well. Alternatives to catching the ball in the CIPOS Protocol for Children could be using the Safe Place to interrupt the process, or drawing a Safe Place and using the picture. The CIPOS method can motivate the child to tolerate stressful memories or fear of the future and can be a very helpful bridge between resource work and trauma work.
This chapter provides guidelines for psychologists to use when assessing behavioral, social, and emotional functioning of culturally and linguistically diverse (CLD) children and adolescents. It begins by describing the typical methods psychologists use to assess these areas, and analyzing them in terms of their effectiveness and validity with CLD children and teens. The chapter then proposes that psychologists use an adaptation of Mash and Hunsley’s developmental systems approach (DSA) to assess CLD children and adolescents. It then discusses specific issues involved in assessment of CLD children and adolescents who display inattentive and hyperactive–impulsive behaviors, externalizing behaviors, internalizing behaviors, and severe social problems. The chapter specifically addresses questions involving the use of the Diagnostic and Statistical Manual of Mental Disorders with CLD children and adolescents to diagnose specific disorders such as attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, anxiety and mood disorders, and autism spectrum disorders (ASDs).
Psychological Assessment of Culturally and Linguistically Diverse Children and Adolescents:A Practitioner’s Guide
This book is intended for school and clinical psychologists who work with children and adolescents, as well as for graduate students who are taking advanced courses in psychological assessment or the assessment of culturally and linguistically diverse children and adolescents. The strategies described in the book are based on up-to-date research on typical cognitive, language, emotional, and social development of culturally and linguistically diverse children and adolescents, including those who are studying in their second language; cultural differences and acculturation; culturally based perspectives on disabilities and disorders; and disorders that might develop due to the challenges experienced by some immigrants and refugees. It discusses demographic, socioeconomic, policy-related, and educational contexts of cultural and linguistic diversity that pertain to the academic achievement of children of immigrants and refugees and other marginalized groups in countries that have high levels of immigration. The book addresses research on the typical developmental trajectory of language and literacy of children and adolescents who must learn in a language that is not the language of their home. It describes methods for assessing children and adolescents’ oral language proficiency (OLP) in their first and second languages, and discusses the issues involved and methods for assessing intelligence, academic achievement, and behavioral, social, and emotional functioning. Strategies for communicating assessment results to culturally and linguistically diverse children and adolescents and to their parents, teachers, physicians, and other professionals who work with them as well as consultation, advocacy, and report writing issues are also described.
It is well-known that chronic, recurrent headaches (HA) are common in children and youth, so much so that they are the cause of considerable discomfort and distress, as well as functional disability. Although prescription analgesics may help relieve periodic HA, some medications to abort HA can contribute to rebound HA if used excessively. Triptan medications and beta-blocking agents are often prescribed not only for adults, but also for children and adolescents. This chapter focuses on the value of stories integral to the hypnotherapeutic experience in teaching young people self-management of HAs. The value of storytelling for children has been well known for centuries by their best therapists, that is, their parents, grandparents, and community elders. Self-hypnosis (SH) has many advantages over pharmacotherapy as a therapeutic strategy for HA. In addition to cost savings, training in SH enjoys the advantage of having no adverse effects as compared with medications.
- Go to chapter: EMDR Assessment and Desensitization Phases With Children: Step-by-Step Session Directions
This chapter describes the procedural steps of the Assessment Phase and Desensitization Phase of the Eye Movement Desensitization and Reprocessing (EMDR) Standard Protocol with detailed scripts for steering a child through each phase. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. Assessment phase note section starts with Target Identification; this is a continuation of what began during the Client History and Treatment Planning Phase. The therapist should already have some idea of what the child may choose given previous target identification procedures such as Mapping and Graphing or other procedures for eliciting targets with children. Once the target has been selected, the therapist continues with Image, negative cognition (NC), positive cognition (PC), validity of cognition (VOC), emotion, subjective units of disturbance (SUD), and body sensation to move on to the desensitization phase.
Parts, alters, and ego states often believe they are living in the past and they are child sized. Orienting them to adult height can lessen anxiety and gives them more concrete proof that the past is different from the present. Child parts are often surprised when they can reach higher than they thought. This adult perspective is reinforced when using dual attention stimulation (DAS). Responses to this exercise will be specific to the part. The parts’ perceived ages rarely appear to change, with their change in perceived body height, for example, one part needed to be told that even if he was adult height, he was too young to drive. If the part is noticing and feeling positive feelings such as “Wow, I can reach all the way to the top of the door!” short sets of DAS is used to install the positive feelings or experience.
Studies have evaluated the usefulness of Eye Movement Desensitization and Reprocessing (EMDR) following disaster events finding that this approach could be effective in significantly reducing post-traumatic symptoms. EMDR has been reported as effective in the treatment of children following a hurricane in Hawaii. Group therapy is a well-proven form of treatment for traumatized children and adolescents. The EMDR-Integrative Group Treatment Protocol (IGTP) was developed by members of AMAMECRISIS when they were overwhelmed by the extensive need for mental health services after Hurricane Pauline ravaged the western coast of Mexico in 1997. This protocol combines the Standard EMDR Treatment Phases 1 through 8. Designed initially for work with children, the EMDR-IGTP has also been found suitable for group work with adults. The protocol is structured within a play therapy format and has been used with disaster victims ages 7 to 50 +.
- Go to chapter: Using Olfactory Stimulation With Children to Cue Resource Development and Installation (RDI)
According to Korn and Leeds, the main goal of developing and installing resources is to increase the client’s capacity for self-regulation by enhancing their ability to access memory networks that contain adaptive and functional information. The Resource Development and Installation (RDI) Protocol should only be considered based on specific criteria that suggest it is needed for the individual child. The purpose of doing RDI is to increase the child’s ability to change state adaptively and tolerate disturbance so the child can prepare for trauma reprocessing. Traumatized children deserve to be treated with the full eye movement desensitization and reprocessing (EMDR) reprocessing protocol so that they can make a complete recovery. Because of the short attention span in children, this protocol may take two sessions to complete. Often, school-aged children can do the protocol in one session.
This chapter describes the interacting forces, understanding the self, identity and emotions. It examines adolescent self and identity, which will serve as a basis for understanding much about the social and emotional world of adolescents. The adolescent years bring with them the long process of departing childhood and emerging into adulthood. Similar to many aspects of development during adolescence that proceed somewhat differently based on gender, males and females differ in the process of self-exploration and identity formation as well. Sexual experimentation is common during adolescence as part of this gender identity struggle. An inability to develop a mature ethnic identity may entail denying one’s culture of origin, whereas a healthy identity process may result in adolescents who are proud of both their culture of origin and the culture they find themselves in currently.
The most challenging and arguably most important part of any assessment is the diagnostic formulation and recommendations for intervention. This chapter explains clinical decision making and diagnostic formulation using a developmental systems approach (DSA) that is based on developmental bioecological theory. It provides suggestions for organizing assessment data and methods for thinking about the data in order to formulate the case systemically. The chapter discusses key issues involved in linking assessment with academic and psychosocial intervention. It reviews the knowledge, strategies, skills, and attitudes that are essential competencies for psychologists who conduct assessments with culturally and linguistically diverse (CLD) children and adolescents. Assessments and intervention with CLD children and adolescents are both challenging and rewarding. Psychologists who work with these children and families effectively have a set of attitudes that stimulate them to find information and research, as well as develop effective strategies.
Eating disorders (EDs) are a complex and comparatively dangerous set of mental disorders that deeply affect the quality of life and well-being of the child or adolescent who is struggling with this problem as well as those who love and care for him or her. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines specific criteria for the diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or ED. Treatment of eating disordered behavior typically involves a three-facet approach: medical assessment and monitoring, nutritional counseling, and psychological and behavioral treatment. Cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are also evidence-based approaches to treatment for AN. The treatment of EDs should be viewed as a team effort that integrates medical, nutritional, and mental health service providers.
Stress is a ubiquitous experience in the lives of children and adolescents, regardless of the schools they attend, their families’ income, or the neighborhood in which they live. There is clear evidence correlating low socioeconomic status (SES) with increases in exposure to violence and other traumatic and stressful experiences. Gender and age also are important factors to consider as related to the amount and type of stress experienced by youth. The three main allo-static systems involved in physiologic reactions to stress include the nervous system, the endocrine system, and the immune system. "Zippy’s Friends" is a school-based mental health promotion and intervention program for younger students in Kindergarten through first grade. The Zippy’s Friends program encourages students to understand their feelings and behavior that facilitates self-reliance and self-confidence. The three strategies of coping skill training, stress management, and mindfulness all show promise for very young children to high school students.
- Go to chapter: Evidence-Based Interventions for Persistent Depressive Disorder in Children and Adolescents
Depression in children and adolescents is a serious, potentially life-threatening problem. Traditionally, depression has been diagnosed using two primary categories: major depressive disorder (MDD) or dysthymic disorder (DD). When compared with youth diagnosed with MDD, children and adolescents with persistent depressive disorder (PDD) are at increased risk for having a comorbid psychiatric disorder. The most common treatments of depression include various forms of interpersonal psychotherapy (IPT), cognitive behavioral therapy (CBT), and psychotropic medication. This chapter provides summary of the step-by-step implementation of IPT for depressed adolescents (IPT-A). Many youth struggle with chronic, sometimes debilitating depression for extended periods of time, leading to underachievement, secondary substance abuse, school failure and drop-out, violent or self-harming behavior, and even death by suicide. Clearly, evidence-based psychotherapeutic interventions are needed.
This chapter discusses comprehensive school crisis interventions, identifies the characteristics that define a crisis, finds ways to assess for the level of traumatic impact, and determines what interventions can be provided to help with response and recovery. It highlights the PREPaRE Model of crisis prevention and intervention. There are six general categories of crises: acts of war and/or terrorism; violent and/or unexpected deaths; threatened death and/or injury; human-caused disasters; natural disasters; and severe illness or injury. Children are a vulnerable population and in the absence of quality crisis interventions, there can be negative short- and long-term implications on learning, cognitive development, and mental health. Evidence-based interventions focusing on physical and psychological safety may be implemented to prevent a crisis from occurring or mitigate the traumatic impact of a crisis event by building resiliency in students. Crisis risk factors are variables that predict whether a person becomes a psychological trauma victim.
This chapter comes from an integrative/holistic approach to play therapy. Although the foundation is influenced by the work of Carl G. Jung, it is integrative because it focuses on practices from many other schools of psychotherapy as well. The chapter concentrates on directive approaches of using trays of sand and small figures as a therapeutic tool in the play therapy room. Jung’s psychology, also known as analytical or depth psychology, is not a tool, methodology, or even a group of techniques, but a way to gain insights that can influence psychic healing. The child’s psyche leads the process in Sandtray-Worldplay. Symbolic images become concrete as they bring powerful insights into consciousness. The builder and the witness travel together through four stages in Sandtray-Worldplay: building and observing, experiencing and reflecting, joint experiencing, and photographing. The sandtray process is led by the builder and facilitated by the witness/therapist.
- Go to chapter: Evidence-Based Interventions for Major Depressive Disorder in Children and Adolescents
Depression is a chronic, recurring disorder that impacts children’s academic, interpersonal, and family functioning. The heritability of major depressive disorder (MDD) is likely to be in the range of 31% to 42%. This chapter begins with a brief overview of the etiology of depression. It presents a description of a cognitive behavioral therapy (CBT) intervention designed to be delivered in a group format, an individual interpersonal intervention, and an individual behavioral activation (BA) intervention that includes a great deal of parental involvement. The ACTION program is a manualized program that is based on a cognitive behavioral model of depression. There are four primary treatment components to ACTION: affective education, coping skills training (BA), problem-solving training, and cognitive restructuring. The chapter concludes with a brief discussion of universal therapeutic techniques to be incorporated into work with depressed youth regardless of the therapeutic orientation or treatment strategy.
Practicing Cognitive Behavioral Therapy With Children and Adolescents:A Guide for Students and Early Career Professionals
This book is dedicated specifically to increasing the confidence and professional competence of graduate students and early career professionals who use cognitive behavioral therapy (CBT) with children and adolescents. It shows some opening remarks for mental health professionals (MHPs) and trainees who are new to doing CBT and positive psychology (PP) treatments with kids suffering from an internalizing disorder. Behavioral activation is a tried-and-true stable of CBT. A common presenting complaint among depressed or stressed kids is poor sleep. The book shows some of the strategies for combating insomnia. Problem solving is another staple of CBT. The methodology for problem solving is a little bit different if it is done with an individual kid or in a family session. The factors to be considered to introduce communications training and problem solving in a family or an individual session are: age, maturity level, and psychological mindedness of the child. Exposure procedure is used for kids who are treated for anxiety. This chapter shows a list of common exposures among anxious youth. Physiological calming and coping thoughts are the two popular techniques for supporting exposures. Involving the parent is often key with doing exposures. The book also presents some of the principles and methodologies with regard to parent interactions. It is important for parents to be open with their kid about their thinking about the value of a mental health evaluation. Sometimes parents ask for guidance about how to have the discussion with their kid.
This chapter describes the growing impact of internet addiction on children and adolescents. It focuses on assessment methods that practitioners working with this population can use to measure and assess the behavior. The chapter explains how practitioners can develop their own screening tools of media use for children and adolescents. It outlines comprehensive parenting guidelines based on the developmental age of the child to best integrate technology at home. Issues of screen time impact a child’s moods and feelings. Children and adolescents who suffer from anxiety, especially social anxiety, are more likely to develop an addiction to technology. The chapter describes assessment methods such as Parent–Child Internet Addiction Test (PCIAT), which assists in clinical evaluation of children suspected to suffer from addiction and Problematic and Risky Media Use in Children Checklist. The chapter describes 3–6–9–12 prevention for screen addiction outlining steps parents can take at each child’s age.
- Go to chapter: Evidence-Based Interventions for Written-Language Disorders in Children and Adolescents
Writing is a fundamental communication skill that is important for everyday success. Children and adolescents use written language to communicate their thoughts, ideas, and knowledge to teachers in school; send messages to friends; write papers and reports; and engage in expository writing activities. Writing is an exceptionally complex task composed of multiple processes. Theories of writing development recognize three stages of writing, including planning or prewriting, drafting or composing, and revising or editing phases. This chapter focuses on writing instruction/intervention and student motivation. Effective writing instruction relies on evidence-based instructional approaches for developing and increasing writing skills related to planning, drafting, and revising tasks. In addition, it is important to consider student motivation as a primary reason for students not demonstrating success with written-language tasks. Self-monitoring has been shown to increase students’ academic engagement during writing as well as improve the writing performance of students with learning disabilities.
- Go to chapter: Evidence-Based Interventions for Promoting Subjective Well-Being in Children and Adolescents
Perceived quality of life is shaped by internal beliefs and social interactions. There is empirical support for the dual nature of emotions in mental health, both among adults and youth. Although many well-being studies have focused on adults, research over the past two decades has examined subjective well-being (SWB) in school-aged youth. There are empirically validated SWB promotion strategies that warrant attention. This chapter provides an overview of a number of these programs and strategies that have been used to foster youths’ positive SWB, with a particular focus on school-based practices. It describes the benefits of SWB among youth, describes specific domains that have been addressed vis-à-vis SWB promotion strategies and summarizes multicomponent programs and narrowband strategies that have been shown to promote SWB levels. The chapter concludes with a description of the factors to consider when implementing efforts to foster SWB and provides key resources to support these efforts.
This chapter provides a description of peer-assisted learning strategies (PALS), a research-based classwide intervention that can be used as part of core instruction linked to multitiered models of prevention and intervention. During the past two decades, PALS has been developed and evaluated for children in prekindergarten to high school, and separate programs for reading and mathematics. PALS researchers worked for several consecutive years during the late 1990s with kindergarten teachers in Nashville to develop Kindergarten-PALS (K-PALS). PALS effects were not moderated by learner type, suggesting that PALS can be used successfully in classrooms in which students with learning disabilities (LD) are included. Each of the K-PALS lessons comprises three parts: a teacher-directed Sound Play activity that provides phonological awareness (PA) practice; a Decoding Lesson that addresses graphemephoneme correspondence (GPC), sight word recognition, decoding, and sentence fluency; and Partner Reading.
This chapter reviews the research on expect respect, second step, and the recognize, understand, label, express, and regulate emotions (RULER) program, curricula with outcome data from US schools for step-by-step implementation by mental health professionals in the hopes of ameliorating this serious epidemic and enhancing the academic, behavioral, social, and emotional functioning of children and adolescents. School bullying and peer victimization are pervasive phenomena that affect many youth. Bullying may inflict harm or distress on the targeted youth including physical, psychological, social, or educational harm. Direct bullying is a relatively open aggressive act on the targeted youth, whereas indirect bullying is not directly communicated to the student being targeted. Moreover, physical, verbal, relational, and damage to property have been identified as specific forms or dimensions of bullying. Positive Behavioral Interventions and Supports (PBIS) is an evidence-based framework for reducing a wide variety of problem behavior in school settings.
- Go to chapter: Evidence-Based Interventions for Elimination Disorders in Children and Adolescents: Enuresis and Encopresis
Evidence-Based Interventions for Elimination Disorders in Children and Adolescents: Enuresis and Encopresis
Elimination disorders in children, including encopresis as well as nocturnal and diurnal enuresis, are common causes of concern for parents. Although these toileting problems are often grouped together when discussing child and adolescent behavioral and health interventions, their etiology, associated complications, and recommended interventions are diverse enough that for the purposes of adequately describing intervention programs for each, this chapter addresses one of the three elimination disorders. Diurnal enuresis, also referred to as “daytime enuresis” or “daytime urinary incontinence”, is characterized by typically involuntary daytime wetting. The prevalence of nocturnal enuresis in children decreases as children grow older. There are two types of nocturnal enuresis: primary and secondary. Toileting difficulties are common concerns of parents of young children. It is fortunate that there are intervention programs based largely on behavioral principles that can be implemented by parents either alone or with guidance from a clinician.
A specific phobia is characterized by an excessive and persistent fear of a specific object or situation that almost always provokes a negative avoidant response. Treatment of specific phobias in children is particularly important because phobias may persist over the course of a lifetime, and may result in other disorders such as anxiety, mood, and substance-use problems. Heritability is thought to play a modest but significant role in the development of specific phobias, with up to one third of the variance of specific phobias explained by genetic factors. This chapter discusses cognitive behavioral therapy (CBT) and one-session treatment (OST), a specific variant of CBT, as well as the role parents may play in the treatment process. It briefly comments on systematic desensitization, which has historically been used to treat specific phobias in children and adolescents.
Since 2000, the number of children and adolescents presenting to the emergency room in psychiatric crisis has nearly doubled, with suicidality among the most common presenting problem. In order to work with this population, it is important to understand the epidemiological trends, prevalence, and incidence rates of child and adolescent suicidality and to identify unique and common risk and protective factors. This chapter addresses these issues, deconstructs myths and misconceptions related to suicide among children and adolescents, and highlights the importance of developmental issues with this population. It also provides an overview of empirically grounded strategies for effective assessment and treatment of this population. Parents have reported that most important to them following their child’s suicide attempt is first keeping their child safe, followed by identifying what caused or triggered the suicide attempt, building strategies to prevent another suicide attempt, and improving communication and building trust for the future.
Play therapy has been recognized in the counseling profession as a developmentally appropriate model for working with children and adolescents. This book provides a comprehensive introduction to structured, prescriptive approaches to play therapy to those desiring to gain more information and knowledge about the use of different directive play therapy modalities. It introduces the unique integration of play therapy and different theoretical models and encompasses the essential concepts and practices of directive play therapy. Most importantly, the book shares some guidelines for planning and selecting toys and materials for a directive approach. It also incorporates settings and skills necessary for effective implementation and addresses common questions asked about the use of these. The book provides the exploration and detailed description of various theoretical approaches to directive play therapy: post-Jungian directive sandtray in play therapy, solution-focused play therapy, eye movement desensitization and reprocessing and play therapy, directive play therapy techniques in trauma-focused cognitive behavioral therapy, child parent relationship therapy, creativity in play therapy using technology, directive filial therapy models with very young children, humanistic sandtray therapy with children and adults, and directive approaches to working with parents. The distinctive techniques and processes of each of these approaches are explained. Finally, case examples are given to demonstrate their application and implementation.
Selective mutism (SM) disorder is caused neither by an unfamiliarity with the language used in a specific social situation nor by a communication disorder. According to Diagnostic and Statistical Manual of Mental Disorders (DSM-5), SM is considered to be an anxiety disorder and may coexist with social anxiety disorder (SAD) and autism spectrum disorder (ASD). It may co-occur with a variety of emotional responses, including ‘excessive shyness, fear of social embarrassment, social isolation and withdrawal, clinging, compulsive traits, negativism, or mild oppositional behavior’. Because of a substantial overlap between SM and SAD, it is widely believed that the disorders may have similar genetic etiologies. Video self-modeling (VSM) is the use of video to depict the child as a model engaged in appropriate and exemplary behavior as a treatment to improve target behaviors. Although a variety of interventions have been used with SM, behaviorally based techniques are the most successful.
- Go to chapter: Evidence-Based Interventions for Autism Spectrum Disorders in Children and Adolescents
Autism spectrum disorder (ASD) is a range of complex neurodevelopmental disorders characterized by deficits in social development, communication, repetitive behaviors and/or interests, and, in some cases, cognitive delays. This chapter proposes that educators should build an approach that uses a combination of evidence-based practices when designing and implementing interventions for students with ASD. It is important to note that interventions for students with ASD include each of the following strategies: individualized instruction that incorporates choice and preference; functional programming; systemic instruction provided within a structured environment; and collaboration with families. Such programming should steadily expose students with ASD to cues, prompts, and interesting and motivating stimuli, as well as employ consistent feedback and repeated exposure in order to be most effective. The family members of a student diagnosed with ASD most often has the most insight into their child’s needs, styles, strengths, and interests.
- Go to chapter: Evidence-Based Interventions for Obsessive-Compulsive Disorder in Children and Adolescents
The content of the obsessions and compulsions varies among individuals with obsessive-compulsive disorder (OCD); however, there are five themes that are commonly experienced across both children and adults: contamination, symmetry/ordering, forbidden or taboo thoughts, harm, and hoarding. Notably, OCD becomes more gender balanced into adolescence and adulthood. Comorbid diagnoses are common among youth with OCD. Common comorbid disorders include anxiety disorders, tic disorders, attention deficit hyperactivity disorder (ADHD), and major depressive disorder. The etiology of OCD is multidetermined with behavioral, cognitive, genetic, and biological factors being implicated. This chapter describes three successful cognitive behavioral therapy (CBT) interventions: CBT with exposure and response prevention (ERP), family-based CBT with ERP, and cognitive therapy interventions that can be used in conjunction with ERP. Treatment guidelines for pediatric OCD suggest the most efficacious treatment is CBT with ERP, either alone or in combination with pharmaco-therapy for the most severe cases.
This chapter focuses on obsessive-compulsive behaviors in children and adolescents. Classification issues based on the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition;
DSM-5) and the Individuals with Disabilities Education Improvement Act ( IDEA) are discussed. An examination of cultural issues related to this disorder are also addressed in the chapter. The influence of OCDon a child’s social–emotional and behavioral functioning are examined. School-based academic and social–emotional supports are included in the chapter as well as school-based mental health interventions.
- Go to chapter: Evidence-Based Interventions for Traumatic Brain Injuries and Concussions in Children and Adolescents
Evidence-Based Interventions for Traumatic Brain Injuries and Concussions in Children and Adolescents
This chapter discusses methods, procedures, and interventions that have been successful in working with children and adolescents with Traumatic brain injuries (TBI) and/or concussions and for which there is empirical and clinical support. It provides empirically supported treatments that may be implemented in schools and clinics for youths with TBIs. TBIs are insults that occur from an event external to the individual. These can include open or closed head injuries and are often classified as mild, moderate, or severe. The majority of TBIs in childhood are closed head injuries and involve rapid acceleration, deceleration, and/or rotation of the head in space without impact with the skull. The level of severity depends on the physical and cognitive deficits associated with the injury. The Glasgow Coma Scale (GCS) is a commonly used scoring system used to assess the severity of acute brain injury.
Children heal through play; it is their work. With posttraumatic stress, however, a child can be so shutdown and isolated within himself or herself that even the safe, welcoming environment of the play therapy room is not enough to unlock her chains. Such an environment creates a fear of self-expression. These behaviors and feelings have been documented by many who have researched posttraumatic stress disorder (PTSD) in children. The something more that is needed is Eye Movement Desensitization and Reprocessing (EMDR) therapy. EMDR therapy includes the Adaptive Information Processing (AIP) model, memories, neurological processes, and a distinct eight-phase integrative treatment approach using bilateral stimulation (BLS). Dysfunctional stored memories of events contain emotions, physical sensations, and beliefs that can become intrusive and result in hyperarousal and avoidant behaviors. EMDR therapy facilitates reprocessing the implicit to become explicit and useful. The therapy uses integration of mind, heart, and body at its core.
- Go to chapter: Evidence-Based Interventions for Tourette’s and Other Chronic Tic Disorders in Children and Adolescents
Evidence-Based Interventions for Tourette’s and Other Chronic Tic Disorders in Children and Adolescents
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists two chronic tic disorder diagnoses, namely, persistent motor or vocal tic disorder (PMVTD) and Tourette’s disorder (TD). Both disorders require symptom onset before age 18 years and require the clinician to rule out alternative causes of tics, including substance abuse and other medical conditions. Tics may be categorized as either simple or complex. Children with tic disorders may be most impaired by comorbid conditions and associated features, including deficient social skills, sleep problems, anxiety and/or depression, obsessive-compulsive disorder (OCD) symptoms, and attention deficit hyperactivity disorder (ADHD) symptoms. A review conducted in 2007 found that only two approaches—habit reversal therapy (HRT) and exposure and response prevention (ERP)-have adequate evidence to treat tic disorders and TD. Tourette’s disorder and other chronic tic disorders are childhood-onset conditions characterized by sudden, involuntary movements or vocalizations.
This chapter reviews current research and practice regarding persistent depressive disorder (
PDD). This chapter highlights the diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition; DSM-5) as well as information regarding potential school-based eligibility for special services for students with depression. Risk factors and behaviors in the home and school are reviewed. The school psychologist’s role in assessment, advocacy, consultation, and therapeutic intervention are explored.
Pediatric bipolar disorder (PBD) has been associated with a number of negative behavioral, academic, and interpersonal outcomes for children and adolescents. It initially received a disruptive behavior disorder diagnosis. High rates of comorbid anxiety disorders have also been found in children with PBD. Psychoeducational psychotherapy (PEP) uses a biopsychosocial model and combines family therapy, psychoeducation, and cognitive behavioral therapy (CBT) techniques with the goal of helping families to better understand and manage the symptoms of PBD and coordinate more effective treatment. This chapter focuses on a description of PEP, including three key interventions of this therapeutic approach: Psychoeducation and Motto, Building a Tool Kit, and Thinking-Feeling-Doing. PEP is a manual-based treatment designed for youth with mood disorders and their caregivers, broken down into separate youth and caregiver sessions. Sessions focus primarily on psychoeducation and skills building and are delivered in individual family (IF-PEP) and multiple family formats (MF-PEP).
Many children experience the death of someone close to them before the age of 18 years. This chapter reviews the effects of bereavement on children’s functioning and the risk and protective factors that exacerbate or mitigate grief-related problems. It provides step-by-step instructions for two evidence-based interventions for school-aged children and adolescents. Childhood traumatic grief refers to a condition in which children develop trauma-related symptoms that interfere with their ability to appropriately mourn a death. The Family Bereavement Program (FBP) is a theory-based intervention for parentally bereaved children and their surviving caregivers. The child component focuses on increasing self-esteem, reducing negative appraisals of stressful events, strengthening youths’ relationships with their caregivers, strengthening coping skills, and increasing adaptive emotional expression. The Grief and Trauma Intervention (GTI) is commonly implemented in schools and community-based settings after children’s exposure to a traumatic, violent, or disastrous event.
This chapter focuses on disinhibited social engagement disorder (
DSED) and its impact on children. Diagnostic issues related to this disorder are examined, particularly in comparison to criteria for reactive attachment disorder ( RAD). The chapter also explores the functioning of a child with DSEDacross social–emotional, behavioral, and learning domains. Implications for school psychologists are addressed. Educational supports and school-based mental health interventions are discussed.
This chapter covers Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition;
DSM-5) criteria for Social Anxiety Disorder and potentially relevant federal educational protections, including the Individuals with Disabilities Education Improvement Act ( IDEA) classifications of Emotional Disturbance and Other Health Impairment and supports offered through Section 504 of the Rehabilitation Act of 1973. Risk/protective factors, family predictors, common comorbid disorders, and cultural considerations are reviewed. Epidemiological studies estimating the prevalence of social anxiety disorder in the United States and across the world are summarized. Validated assessment tools for children and adolescents, including those that measure a number of anxiety disorders and those specific to social anxiety disorder, are included. Further, evidence-based treatments, particularly cognitive behavioral therapy, and social skills interventions, are highlighted. The impact of social anxiety disorder on social development in children and adolescents is summarized. The chapter offers activities and services that school psychologists can provide through direct service, consultation, support of families, and advocacy efforts.
A consensus among professionals and the general population holds that helping children develop healthy self-concepts is a worthwhile goal. This chapter describes how healthy self-concepts are developed naturally and remediated through evidence-based interventions. Interventions for enhancing self-concept require a sound working theory, receptive and informed participants, thoughtful planning, and treatment fidelity. This chapter provides the reader with the theory and methodology to develop positive self-concepts in children and adolescents. There are a number of factors and models of self-concept that describe different factors contributing to self-concept development. The prominent models include cognitive and behavioral orientations, each with related contributing factors. People receive environmental feedback on their behavior or attributes from two feedback modes or perspectives-personal perspective and other perspective. The feedback individuals receive can be evaluated according to four standards include the absolute, comparative, ipsative, and ideal.
Homework completion is viewed as a beneficial contributor to student learning and to the fundamental personal characteristics that underpin student academic behavior. This chapter promotes a greater understanding of the benefits of homework compliance while providing evidence-based expectations for appropriate homework loads, special education use of homework, and best practices in homework compliance management. It provides readers with empirically supported strategies for helping parents and teachers maximize the benefits of student homework completion, while reducing parental and student angst associated with compliance enforcement. The chapter offers an approach to promoting collaboration between school personnel and parents to enhance students’ academic competence using a multifaceted, school-based problem-solving model. Homework serves four primary instructional purposes: practice, preparation, extension, and integration. To augment the retention and learning of classroom material, numerous research-based interventions and strategies have been designed to enhance homework performance in children and adolescents.
This chapter discusses the differences among children, preteens, and adolescents and the implications for treatment planning and treatment goals for these groups. It also discusses the inclusion of family and individual therapy, the inclusion of the school as part of the milieu, and some unique problems that may need to be addressed. The patient in the child cohort is cognitively concrete, and the clinician interventions may be as much family based as they are individual. Although there may be some depression and suicidality present, impul-sivity and aggression tend to be more common problems. The successful group therapy approach is group play for socialization and art therapy for expression. Family therapy is important for addressing behavioral issues in the home and for monitoring progress. The child and adolescent cohort is the only partial hospitalization program (PHP)/intensive outpatient program (IOP) cohort for which both family and individual therapy are program expectations.
This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. Problem solving is another staple of CBT. The methodology for problem solving is a little bit different if it is done with an individual kid or in a family session. In research looking at what mediates benefits in family therapy, communications training and problem solving come out on top. This is a monstrously helpful technique. And it saves individuals and families all kinds of time and distress. The author appreciates that a mental health professional (MHP) gets extra data and can also try to be helpful with a wider range of problems that could be affecting the identified child client. The factors to be considered to introduce communications training and problem solving in a family or an individual session are: age, maturity level, and psychological mindedness of the child.
Solution-focused brief therapy (SFBT) principles have been advocated for children, adolescents, and adults. SFBT states that the client brings strengths and capacities to access and develop to make life more satisfactory. The counselor demonstrates confidence in the client’s ability to make positive changes in his or her life by accessing and using inner resources. This creates an atmosphere where strengths move from the shadows to the foreground and strengths are found in the spaces between problems. The client is the expert, and the counselor is responsible for developing a collaborative context and helping the child or adolescent articulate desired changes. The counselor and client create a cooperative context within which solution building ensures information is collected in order to understand what will be different once the problem is solved. Language and techniques address how problems will be solved rather than what caused the problem.